Ebola Preparedness and Health Information Sources Among Undergraduate Nursing Students in Egypt: Cross-Sectional Study (Preprint)

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BACKGROUND Ebola disease preparedness is relevant to nursing education because nursing students may contribute to triage, infection prevention and control (IPC), exposure reporting, risk communication, and community education during outbreaks. Preparedness evidence from countries without current transmission remains limited, and students may rely on variable-quality online or social-media information. OBJECTIVE This study assessed Ebola-related knowledge, preparedness attitudes, and self-reported preventive practices among undergraduate nursing students in Egypt; described their main information sources; and examined associations of knowledge and attitudes with preventive practice. METHODS A cross-sectional survey was conducted among 250 undergraduate nursing students at an Egyptian public university. The self-administered questionnaire included 20 knowledge items, 14 attitude items, and 15 preventive-practice items, together with demographic, training, and main information-source items. Knowledge was scored 0-20, attitude 14-70, and practice 0-45. One reverse-worded attitude item had a negative corrected item-total correlation and was omitted from the refined 13-item attitude score. We report descriptive statistics, score reliability, exploratory item-structure evidence, Pearson correlations, and a multiple linear regression model predicting self-reported preventive practice. RESULTS The mean knowledge score was 11.72 (SD 7.70) of 20; 127 of 250 students (50.8%) met the prespecified good-knowledge category. The refined attitude score averaged 44.79 (SD 17.52) of 65 (n=247), and the practice score averaged 33.46 (SD 14.45) of 45. Internet or social media was the most frequently reported main information source (119/250, 47.6%); only 61 of 250 students (24.4%) reported previous Ebola-specific education or training. Internal consistency was high for knowledge (alpha=.969), refined attitude (alpha=.983), and practice (alpha=.980). Knowledge (r=.326, P<.001) and refined attitude (r=.587, P<.001) were positively associated with practice. Together, they accounted for 37.9% of the variance in practice; attitude had the larger standardized association (beta=.539 vs beta=.192; both P<.001). CONCLUSIONS The findings identify marked variability in Ebola preparedness and reliance on internet or social-media information among nursing students. Results support structured, species-specific outbreak-preparedness teaching that combines current clinical and public-health guidance with IPC skills, exposure-reporting pathways, risk communication, stigma reduction, and digital information appraisal. Because the study used a single-site convenience sample and self-reported practice, the findings should inform formative curriculum planning rather than competence certification. CLINICALTRIAL NA

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